酒精使用障碍与帕金森病风险：来自瑞典全国队列研究 1972-2008 年的发现。
Alcohol use disorders and risk of Parkinson's disease: findings from a Swedish national cohort study 1972-2008.
机构信息
Department of Public Health Sciences, Division of Social Medicine, Karolinska Institutet, Stockholm, Sweden.
出版信息
BMC Neurol. 2013 Dec 5;13:190. doi: 10.1186/1471-2377-13-190.
BACKGROUND
Alcohol has been suggested to be either protective of, or not associated with Parkinson's disease (PD). However, experimental animal studies indicate that chronic heavy alcohol consumption may have dopamine neurotoxic effects relevant for PD. We studied the association between diagnosed alcohol use disorders and PD.
METHODS
All individuals in Sweden admitted with a diagnosis of an alcohol use disorder or appendicitis (reference group) between January 1, 1972 and December 31, 2008 were identified through the Swedish National Inpatient Register, and followed for up to 37 years for a diagnosis of PD. We estimated hazard ratios (HR) with 95% confidence intervals (CI) and adjusted for age and sex.
RESULTS
We found 1,741 (0.3%) cases of PD in the cohort of 602,930 individuals, 1,083 (0.4%) among those admitted with an alcohol use disorder and 658 (0.2%) of the individuals admitted with appendicitis. The mean follow-up time was 13.6 and 17.1 years, respectively. The HR for PD associated with an alcohol use disorder was 1.38 (CI 1.25-1.53) adjusted for age and sex. When the risk was estimated in age groups for first hospital admission with PD the highest risk was observed in the lowest age group, ≤44, HR 2.39 (0.96-5.93), adjusted for age at exposure and sex.
CONCLUSIONS
A history of an alcohol use disorder conferred an increased risk of admission with a diagnosis of Parkinson's disease in both women and men. In particular, the risk seemed higher at lower ages of first admission with Parkinson's disease.
背景
有研究提示，酒精可能对帕金森病（PD）具有保护作用，也可能与 PD 无关。然而，动物实验研究表明，慢性大量饮酒可能对 PD 具有多巴胺神经毒性作用。本研究旨在探讨已确诊的酒精使用障碍与 PD 之间的关系。
方法
通过瑞典全国住院患者登记处，确定了所有在 1972 年 1 月 1 日至 2008 年 12 月 31 日期间因酒精使用障碍或阑尾炎（参照组）住院的个体，并对其进行了长达 37 年的随访，以诊断 PD。采用危险比（HR）及其 95%置信区间（CI）评估与酒精使用障碍相关的 PD 发病风险，并进行年龄和性别调整。
结果
在 602930 例个体组成的队列中，我们发现了 1741 例（0.3%）PD 病例，其中 1083 例（0.4%）来自酒精使用障碍患者，658 例（0.2%）来自阑尾炎患者。平均随访时间分别为 13.6 年和 17.1 年。在校正年龄和性别后，酒精使用障碍与 PD 的 HR 为 1.38（95%CI 1.25-1.53）。按首次 PD 住院年龄分组估计风险时，观察到最低年龄组（≤44 岁）的风险最高，HR 为 2.39（95%CI 0.96-5.93），校正暴露年龄和性别后。
结论
有酒精使用障碍史的个体患 PD 的风险增加，无论男女均如此。特别是，在首次 PD 住院的较低年龄组中，风险似乎更高。
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